Clinical Supervision

Time to Reflect on Practice in a Guided Conversation

My Background in Clinical Supervision:

My enthusiasm for clinical supervision in SLT started when I did my MA in Professional Training and Development. I discovered reflective practice, mentoring and clinical supervision. I was a Clinical Lead at the time and very used to giving advice but not so aware of models for listening and reflection. RCSLT were developing their reflective practice resource at the time so I got involved in that work too. Since then I’ve devised and delivered training and set up clinical supervision structures for Allied Health Professionals in two organisations. Now Clinical Supervision is a cornerstone of Communicology Consultancy.

My clinical specialisms are in Special Educational Needs, Services to Education, Complex Needs and ASD and I served as an RCSLT Specialist Clinical Adviser in these areas before leaving the NHS in 2019.  I also have specialist skills in Adult Fluency & Voice Therapy.

Your supervision 

This can be group or individual supervision (or sometimes both).  Extended Support/Supervision packages are also available for times of transition or change in your career as an SLT. 

Your supervisory support will be based on reflective, guided conversation & solution focused models. I am especially committed to developing Online Clinical Supervision groups as well as one to one supervision. My approach is to always have a structured evidence based process underpinning supervision sessions. Alongside this building a trusting supervisory relationship which gently challenges each supervisee’s thinking, developing clinical practice and coping skills as busy clinicians. 

“In a Guided Conversation between 2 or more practitioners the insights and ideas come out of the interaction and reflection on events.”

Reflective insights & a way forward

Clinical Supervision is about more than discussing clinical cases. If you ask 5 different people what they think clinical supervision is then they will probably all say different things! 

The model I developed is called Situational Supervision and focuses on ‘caseworking’, and considers wider (3D) aspects than caseload/cases. I actively listen to the material you bring to work on, you tell your ‘stories of practice’. Caseworking situations are ‘freeze framed’ and explored together through the lens of reflective comments/questions giving insight and coaching around taking next steps. 

Situational Supervision includes:

  • how we manage our own caseworking (the demands, the’ juggling’ and how our personal style and character impacts on our caseworking)
  • Changes and transition points (when we change role or job or clinical specialism and our identity as a practitioner)
  • Dealing with day to day ‘mental grime’ of our work (the relationships, barriers & frustrations)
  • Preparing for an interview, difficult meeting, session (anticipating & preparing)
  • Case management & complexity of cases (dilemmas and decisions)
  • Engagement in therapy (the reasons, the challenges and the communication)
  • Overload & Self Care (avoiding burnout and ‘thriving not just surviving”
  • Flourishing & ‘what makes a good day’ at work

Thinking of supervision in terms of Brigid Procter’s model of clinical supervision gives a visual image of a continuum from restorative  to developmental/learning at the other.  Sometimes supervision is closer to the Restorative end of the continuum and sometimes it is closer to the CPD/Learning end. 

If you are in your early career or changing specialism or taking on a leadership role then the focus will be much more on supporting development as you extend your knowledge & skills. 

For experienced practitioners then clinical supervision is usually at the restorative end of the continuum. The session will be a place to ‘check in’, to chat/talk about caseworking that month. Yet there is always some aspect of CPD in a supervision session. 

If you are working independently then your need may be for a ‘sounding board’, a ‘space’ where you take time out to talk about clinical decision making/risk. 

In Situational Supervision the ‘material’ you bring to supervision are the stories about your practice. Sometimes it’s a good news story about something which went well, sometimes it’s a ‘got stuck’ story, a difficult relationship with a professional or client, business development dilemmas. 

Sharing Stories in a Guided Conversation

Deciding on Group or Individual Supervision

This can be a difficult choice. There is a lot of common ground in both types of supervision, but significant differences too.

I’m an enthusiast for group supervision. In a group there is a supportive network of colleagues with listening, supportive insights and gentle challenges to our thinking. Groups are usually closed groups for 3 months before there is a review and any new members can join after that 3 monthly review. The maximum is 6 people in a group, they can work well with 3 or 4 members if there is a strong commitment to attendance. 

Individual supervision is invaluable for situations like:

  • Analysing complex cases and the ‘backstory’ of the case
  • Business changes/development
  • Deciding on changes in job/career
  • Coping at work and looking for strategies to thrive and not just survive

Sometimes both individual and group can be complementary and together give robust supervisory support, even for a short period of time. 

Extended Support Package – for ‘Times of Change’

For those times when you are moving jobs or changing specialism then extended clinical support is available. This involves a monthly individual supervision session plus additional support via email/messenger or telephone calls between sessions. The expectation is that this would be utilised sensibly and not continuously by the supervisee! However a weekly phone call and 2 or 3 emails a week is quite acceptable in this Extended Supervisory Support package. 

An Extended Support Package is also available for those going through uncertainty & re-structure in the NHS. It happens (it happened to me 3 times in 4 years) and it can be hard to keep going and not let it take over your thoughts and impact on homelife. The extended support which is closer to coaching can support you through a difficult time and give you a place to talk and share outside your organisation. 

Supervision for Supervisors

Individual supervision is offered for those who supervise others both as clinical and management supervisors. It is hoped to offer a specific group for supervisors if there is interest in the months ahead. 

Early Career Support Package

If you are in the early stages of your career with a limited support network in your setting then a similar package is available as for Extended Support. You would receive individual supervision and the option of a weekly/fortnightly  phone call and  mail/messenger support between structured supervisions. There is more focus on advisory, clinical support initially as you develop your competencies. You will be supported in the ‘soft skills’ of learning how to time manage your casework/stress levels/networking for future career. 

To Do Lists need to include Clinical Supervision

A 3 hour training session about engaging in the Clinical Supervision process is available for delivery online. 

Training Workshops – ‘Situational Supervision’:

A longer 5 hour training session for those new to the models of reflective practice. 

This can also be adapted and delivered for SLT Assistant practitioners.  

In terms of Clinical Supervision Ruth’s experience /training has involved:

  • MA in Professional Training & Development: modules on Mentorship/Coaching and focusing on Reflective Practice in SLT as action research. This led me to Clinical Supervision as a vehicle for reflective practice for allied health professionals and I began developing training materials for SLTs. 
  • Training colleagues in Reflective Clinical Supervision and Situational Supervision in Yorkshire & Lancashire from 2005 to 2019. The focus was always on ‘how to be a good supervisee’ as well as ‘how to supervise others. 
  • Situational Supervision was developed during a project in 2017 to support therapists and children’s nurses in accessing and delivering casework based clinical supervision. In 2016
  • Clinical Support for Assistant Practitioners: a longer training package focusing on the fundamentals of reflective practice was developed to meet the needs of assistant practitioners. In 2016
  • Appreciative Peer Coaching training and implementation for Children’s Integrated Team of therapists (based on appreciative leadership/mindful leadership & positive therapy (positive psychology approach from Penn State university)
  • Restorative Clinical Supervision package Following learning/training package/ introduced to clinical team in 2018
  • Advanced Clinical Supervision Training SDD Associates in 2020

Professional/Clinical & Management Experience:

I have worked as Clinical Lead in the NHS for ASD, SEND and Fluency in my career. I have led a Schools then Children’s SLT Team of 45 people and Integrated Children’s Therapy & Nursing Teams. While a manager/leader I always maintained a clinical SLT caseload. So juggling priorities was a key skill. 

Clinical Teams benefitted from my interest in positive psychology and solution focused approaches and my commitment to Clinical Supervision. In more recent years an interest in Mindfulness has strengthened and if you do a search on Amazon you will find my indie published books on the theme of mindfulness and slow travel. I am currently working on a book with the working title ‘mindful menopause’ and a second slow travel guide.

Scheduling, Supervision Contract & Cost 

Your schedule of Clinical Supervision is agreed individually. I recognise that intervals between supervision meetings can change over time, perhaps depending on demands and support levels at work. In Independent practice supervision gives a reflective space and reduces any feelings of isolation in clinical practice. A Clinical Supervisory Contract is agreed with the usual ground rules/etiquette for successful supervision. Invoices are sent following each session. 

Cost of Supervision:

Individual Supervision: 

For a 50-60 minute online session: £60

Extended Support Package: 

£80 a month for an agreed timescale

Early Career Support Package:

£65 a month for an agreed timescale

Group Clinical Supervision 

The cost is a £20 contribution to the group. Groups are facilitated by me or another  supervisor from the group. 

Groups are closed groups for 3 months and then reviewed. At the time of review new members may join a group if places are available. Sometimes new groups are set up. Just ask me if you are interested in joining a Clinical Superivision Group. 

Paired Clinical Supervision

This can be set up on request and the cost would be £40 each. 

Supervision Group for Supervisors;

£20 contribution

Supervision Training (online): 

Situational Supervision: 3 hours – £100

Reflective Practice & Situational Supervision: 5 hours – £150

If you run a practice with several clinicians and would be interested in engaging in a contract for supervision for the needs of your staff then please contact me to discuss how this might work in practice. 

Ruth’s Favourite Reflective References:

Driscoll John: Practising Clinical Supervision: A Reflective Approach for Healthcare Professionals (2009)

Proctor Brigid: Group Supervision: A Guide to Creative Practice (Counselling Supervision Series (2008)

Johns Christopher: Mindful Leadership: A Guide for the Healthcare professions(2015)

Wallbank Sonja: Restorative Reilience Through Supervision: An Organisational Training Manual for Health and Social Care Professionals (2015)

Pennebaker James W: Expressive Writing in Psychological Science (2017)

And a summary article at: https://www.journaling.com/articles/expressive-writing-a-tool-for-transformation-with-dr-james-pennebaker-ph-d/

Reflective Models:

During the early stages of your supervision I will introduce different models of reflective practice such as John’s, Kolb, Driscoll, Gibbs and we can explore which model is a ‘best fit’ for your individual style so your supervision becomes a CPD activity giving you a toolkit of ways to support yourself (self reflection) in the future. 

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